Chiropractic around the world - Palmer Alumni are making a difference

cover story

How in the world is chiropractic?

Worldwide Perceptions of Chiropractic and How Palmer’s International Alumni are Advancing its Acceptance

In the United States, where chiropractic was founded, the
profession and its practitioners have been well-accepted for
decades. The same is true in other regions of the world such
as Canada, Australia and most of Europe. But what many don’t
realize is that chiropractic now enjoys nearly worldwide acceptance
with just a few exceptions. And Palmer’s international
alumni have been working diligently for many years to ensure
this worldwide success.

“Chiropractic is now well-accepted worldwide,” says World
Federation of Chiropractic (WFC) Secretary-General David
Chapman-Smith, Esq. “There are doctors of chiropractic
practicing in more than 90 countries, 49 countries have legislation
to recognize and regulate chiropractic practice, and the World
Health Organization (WHO) has policy recommendations to all
national governments that chiropractic should be included in
their health care systems.”

Chiropractic success can be measured by new chiropractic
educational programs. Recently, university-based chiropractic
programs opened in a number of countries in Asia, Europe
and Latin America. “These include six new programs in Latin
America—two in Brazil, one in Chile and three in Mexico,”
adds Mr. Chapman-Smith.

Making strides in Africa

Chiropractic acceptance is growing in Africa. A recent chiropractic
success story was the formation of the African Chiropractic Federation
(ACF) at the WFC Congress in Durban, South Africa, in
April 2013. “Africa is the last world region to form such a regional
organization,” Mr. Chapman-Smith adds. “The AFC was formed
by chiropractors from 11 countries and will hold its first annual
meeting and seminar in Nairobi, Kenya, April 2-4, 2014. Nairobi’s
nine doctors of chiropractic include recent Palmer graduate Dr.
Hamisi Kote Ali (Davenport ’12).”

Additionally, Naa Asheley Ashietey, D.C., Davenport ’11, who
is currently practicing in Tema, Ghana, has been elected president
of the West African Chiropractic Association (WACA).
The WACA was created in April 2012 with a mission to unite
the chiropractors in Ghana to form a stronger force to work
on getting a separate and distinct legislation for chiropractic in
Ghana. The new association is also working to create more
awareness of chiropractic within the chiropractors’ communities.

African chiropractors at the formation of the African Chiropractic Federation.

Another international organization, World Spine Care, founded
in 2008 through the inspiration of Scott Haldeman, D.C.,
M.D., Ph.D., Davenport ‘64, is providing access to chiropractic
around the world. (For more information, see the article in
the Spring 2012 Insights.) Its initial projects are in the village
of Shoshong, Botswana, and in Ranthambhore, India. The
chiropractic clinic in Shoshong has been serving residents in
the community for several years. The first student from the
region is expected to begin studies at Palmer’s Davenport
Campus this fall through a Palmer scholarship.

International Challenges

But these successes are countered by challenges, especially in
Asian countries and small pockets of Europe. “The fight for recognition
continues to be difficult in Japan, South Korea and Taiwan,
where numerous medical and non-medical practitioners oppose
the development of chiropractic, and in central European countries
such as Austria and Hungary, where spinal manipulation is
restricted to medical doctors by law,” Mr. Chapman-Smith says.

It may be tempting for individual chiropractors to take up the
banner of chiropractic in countries where its practice is suppressed
or even illegal, but that’s not always the best way for the
profession to gain broader acceptance, cautions Mr. Chapman-
Smith. “The WFC is working with the WHO and the relevant
national and regional chiropractic organizations, and these battles
will be won over time,” he says. “It’s sometimes counterproductive
for well-intentioned individual chiropractors to take independent
action. It’s important that they work through established professional
organizations.” Individual chiropractors can, however,
encourage people to pursue a career in chiropractic, whether at
Palmer or an educational institution in their home country.

Closing chiropractic's cultural credibility gap in Canada

In recent years, the chiropractic profession has seen tremendous
success in integration and acceptance into Canada’s
mainstream health care system, according to Gregory Uchacz,
D.C., West ’92, Calgary, Alberta, Canada.

“In so many aspects of the Canadian system, chiropractic has
gained access and acceptance as an equal partner,” he says.
“We’ve experienced this in the delivery of services, in research
opportunities and in policy-making decisions. Virtually all
of these were opportunities presented because of greater
integration of chiropractic.”

Despite this progress, challenges remain for chiropractic
in Canada. “In the past two decades we’ve made incredible
gains in chiropractic acceptance, and many chiropractors
have tremendous personal credibility and are excellent
ambassadors for the profession,” Dr. Uchacz says. “However,
the profession is still hindered by a lack of cultural
credibility. Chiropractic as a profession needs to gain
greater cultural credibility in order to gain a higher level
of public access.”

A closer look at chiropractic in Australia

How well-accepted is chiropractic
in Australia? Australia is one of the
countries in which the use of chiropractic
is substantial and its popularity
increasing, reports a recent article,
“Chiropractic in Australia: A Survey
of the General Public,” published
in the September 2013 issue of
Chiropractic Journal of Australia.

This most recent survey of chiropractic,
which included 757 respondents,
found that “Chiropractic is a thriving
profession in Australia … A considerable
number of Australians already
utilize chiropractic services.
Encouragingly, the vast majority of
these consumers are satisfied with the
service provided. … A more active
approach should be taken by chiropractic
practitioners and institutions
to improve the general public’s
knowledge about chiropractic.”

This research demonstrates a widespread
acceptance of chiropractic in
Australia, though there are some
hurdles to overcome. “There’s now
national legislation covering chiropractic
in Australia, which was formerly
state-based,” says Dennis
Richards, D.C., Davenport ’78, the
president of the World Federation of
Chiropractic and a practicing chiropractor
in Tweed Heads, New South
Wales. “The Chiropractic Board of
Australia is one of 15 health profession
registration boards that are part
of our federal government’s Australian
Health Practitioner Regulation
Agency. This means chiropractic is
now ranked on the same level
as these other professions, legally
at least.”

Recent successes aside, chiropractic
in Australia, as in most other
countries, has its detractors. “Recently
chiropractic has been attacked by
pro-medical groups, which have
been able to generate biased coverage
in the media, including on several
TV programs,” Dr. Richards says.
“The attacks are particularly related
to efficacy, safety and chiropractic
care of children. The Chiropractors
Association of Australia has responded
and it’s not clear whether these
attacks hurt or help chiropractic.
Some chiropractors report increased
inflows of new patients after this
'bad' publicity.”

There also is continuing concern
among Australian chiropractors that
the principles of chiropractic philosophy
are not well-taught at some
Australian chiropractic educational
institutions. “It’s important that Palmer
alumni promote the passing down of
this philosophy to students, so they
understand who they are as chiropractors
and what they exist for,” he says.

Palmer alumni have a long history of
leadership roles in Australia at the
state and national levels, as well as
internationally. “Since 1998, there
have only been two years when the
presidency of the Chiropractors’
Association of Australia (CAA) has
not been filled by Palmer graduates,”
Dr. Richards says. “Dr. Laurence
(Laurie) Tassel, Davenport ’85,
served in that position between 1998
and 2002; Dr. Andrew Lawrence,
Davenport ’80, between 2002 and
2005; I served between 2005 and
2009; and Dr. Tassel assumed the
office again in 2011. Dr. Joe Ierano,
Davenport ’97, is president of the
New South Wales state branch of the
CAA. I currently serve as president
of the World Federation of Chiropractic
and Dr. Tassel and I are both on
the WFC Council.”

With all of this progress, what
remains to be done to advance
chiropractic in Australia? “From my
perspective, the task and my goals
are always the same,” Dr. Richards
says. “The lives of the people of the
world will be better if they have
access to quality chiropractic care.
Chiropractic’s safe, gentle, effective
and natural approach truly promotes
health. We should be playing a leading
role in simplifying and spreading
the understanding that health mainly
comes by living healthy lifestyles.
D.D. Palmer described chiropractic
as a philosophy, science and art. We
need to be the best we can be at each
of these, and to pass on that understanding,
knowledge and skill to the
next generation.”

Enormous potential in Eastern Mediterranean and Middle East

Dr. Stathis Papadopoulos addressing
delegates at the multidisciplinary
meeting at the Jordanian University
of Science and Technology on
April 25, 2010.

There are relatively
few chiropractors
practicing in the
Eastern Mediterranean
and Middle
East region, and no
educational institutions
at present. It
will take time for
the profession to
attain the level of
acceptance it enjoys
in either the U.S.
or Europe, says
Efstathios (Stathis)
Papadopoulos,
D.C., FFEAC, FICC,
Davenport ’81,
Lefkosia, Cyprus. Dr. Papadopoulos is the president of
the Eastern Mediterranean & Middle East Chiropractic
Federation (EMMECF), formed in 2010. “The potential
for expanding the chiropractic profession in our region is
enormous,” he adds. “We’re still at the pioneering level.”

When Dr. Papadopoulos was elected regional representative
to the World Federation of Chiropractic (WFC) Council
in 1991, there were only a few well-organized national
associations in the region, and in most countries there
were only one to three individual chiropractors “practicing
quietly and keeping to themselves,” he says. “I decided to
personally visit each country, find the individual D.C.s
and convince them to form national associations to have
someone representing the profession on the ground. I
also encouraged them to apply for membership in the
WFC to have access to its support and specific advice
when contacting their government or facing medical or
other opposition.”

Efforts continue to create an educational institution in the
region. In 2010 there was a major undertaking by
the Jordanian Chiropractic Association, supported by
the EMMECF, the WFC and Canadian Memorial Chiropractic
College, to create a chiropractic program at the Jordan
University of Science and Technology (JUST) in Irbid, Jordan.

“We had good cooperation from the university and all
involved, but unfortunately due to political instability
we could not get the program started,” Dr. Papadopoulos
says. But some good came out of the effort as the EMMECF
was formed by representatives from 11 countries at JUST
on April 25, 2010. “It was a historic decision,” Dr.
Papadopoulos says. Founding members were Bahrain,
Cyprus, Egypt, Iran, Jordan, Lebanon, Palestine, Saudi
Arabia, Syria, Turkey and the United Arab Emirates.

“Palmer College of Chiropractic helped us significantly
by sponsoring the EMME meeting in Egypt in 2008,”
he adds. The meeting featured a two-day extremities
and imaging program presented by Dr. Ed Feinberg,
West Campus professor, and Dr. Tracey Littrell, assistant
professor, Davenport Campus. “Here I must express
our thanks once more to the Palmer Board of Trustees
for its much-appreciated support,” Dr. Papadopoulos
says. “Conditions are now maturing for a chiropractic
education program to be started in Turkey and possibly
also in Dubai.”

A noteworthy milestone for the EMMECF, the WFC and
the profession was the 5th Annual SPINE Conference
(SPINE is the regional affiliate of the North American
Spine Society, representing spine surgeons and other
orthopedic specialists in the Near East area) in Beirut,
Lebanon, in June 2012. It was jointly sponsored by medical
spine societies from the Middle East, the North American
Spine Society, the EMMECF and the WFC. “Following
this successful meeting, the two chiropractic organizations
were asked to sponsor the 2013 SPINE Conference, and
a number of surgeons received their first chiropractic
assessment and treatment,” Dr. Papadopoulos adds.
“Chiropractors also have been invited to become members
of SPINE member societies.”

European Leadership

Generally speaking, chiropractic is more accepted in Western Europe
than in Central and Eastern Europe, mainly because there are no
chiropractic colleges in Central and Eastern Europe. “In Western
Europe, national associations of chiropractors got together as early
as 1932 to establish the European Chiropractors’ Union (ECU) as a
regional body—initially Belgium, Denmark, the United Kingdom
and Switzerland,” Dr. Papadopoulos says.

He adds that the ECU “is the prime example of a well-organized regional
organization. It acts as the nervous system for its 20 member countries.
We need the three levels of organization for the proper development
of the profession: national associations, regional bodies and global
ones such as the WFC. The main purpose of the ECU, and all other
regional bodies, is to unite the profession, promote university-based
chiropractic education and research, uphold the professional standards,
and promote chiropractic legislation and regulation in their region.”

But, as the WFC’s David Chapman-Smith points out, some challenges
remain in Europe. This was reiterated by Dr. Papadopoulos: “In some
European countries, such as Austria and Hungary, chiropractic is
restricted to medical practitioners by law,” he says. “This is where
our profession needs total unity, good organization and capable
leadership to face these issues nationally as well as at the European
Union and global levels. I’m confident that with the recent decision
by the ECU to create the post of secretary general, and the appointment
of Dr. Richard Brown, who’s both a chiropractor and a lawyer,
in that position, the ECU has strengthened its organizational ability
and the future is much brighter for the European countries. In fact,
I can confidently state that Europe is a step closer to becoming the
leading force in the profession.”

Some examples of European successes include:

Switzerland has the highest level of training for chiropractors in
Europe with a six-year program at the University of Zurich
followed by a two-year mandatory graduate education program.
Switzerland also has the widest legal and reimbursement rights
in Europe.

In 2011 the ECU succeeded in achieving a European Standard
for chiropractic awarded by CEN, the European equivalent of the
ISO. The CEN/TC 394 acknowledges chiropractic educational
competencies including preparation for diagnosis and primary
care practice.

The 2012 SPINE Conference in Beirut opened the way for
Eastern Mediterranean chiropractors to join their national spine
societies as full members, which, if handled properly, will open
the door to closer cooperation with M.D.s and others in their
health care systems.

One Alumna's perspective of chiropractic in Peru

Emily Broniak, D.C., Davenport ’06, began working with a
group of chiropractors led by Liam Schubel, D.C., in March of
2006, just five days after her graduation from Palmer’s Davenport
Campus. She’s a chiropractor with Centro Quiropractico
Schubel (CQS) in Northern Peru. CQS now has 14 offices in
Peru and two in the Dominican Republic.

“There are so many people who need help,” Dr. Broniak says.
“More than 30 million people live in Peru and there are probably
less than 50 chiropractors.” She began working in Lima, Peru’s
capital, and stayed there for two-and-a-half years. During that
time she cared for many patients who had traveled more than
10 hours by bus to reach the capital city for chiropractic care.

She and her colleagues soon realized they needed to bring
chiropractic centers closer to the people. During the past five
years, Dr. Broniak has been closely involved in opening CQS
chiropractic offices in northern Peru. “We now have four offices in
three cities—there are two offices in Trujillo, one in Chiclayo and
one in Piura.” In all of these areas, the chiropractors work hard to
educate community residents about chiropractic, including talks
to groups of every size, and appearances on national and local
radio and television programs.

Dr. Broniak was inspired to go to Peru “to serve those
without access to chiropractic care” after a Palmer Clinic
Abroad Program trip to India in 2005. “I wanted to be able
to practice like that all the time instead of taking time off and
traveling to a distant place in order to do it,” she says. “I’ve
started partner programs with orphanages in every city where
we have offices. In Trujillo we’ve been adjusting children in two
different orphanages since 2008. It is so fulfilling to know that
taking care of a child’s nervous system can give them the ability
to think, function, feel, grow and develop to be the best person
they possibly can be … and this can mean the difference
between a marginal life and an outstanding life where they
contribute to society.”

The group cares for all types of patients, from children
to senior citizens, and those from all walks of life, including
volunteer firefighters. “In Peru there are only volunteer firefighters;
the country doesn’t have the infrastructure or resources to
pay them for their services. About three years ago we began
offering free chiropractic care to any volunteer firefighter in
Trujillo in order to appreciate what they do for the community.

Dr. Broniak says they are always looking for more chiropractors
to join them in Peru or the Dominican Republic. Visit
schubelvisionworldwide.com/associate.html if you are interested
in working with CQS.

Chiropractic identity key to worldwide acceptance

To increase its worldwide market share,
the chiropractic profession is sorely in need
of an understandable, widely-accepted
public identity. Three years ago Palmer
joined the WFC in its efforts to establish
a chiropractic identity by embarking on
the creation of the Palmer identity for
chiropractors: The primary care professionals
for spinal health and well-being.
(See Is chiropractic ready for primetime?.)

“If any service or product is going to be
accepted and successful it needs a clear
market identity,” Mr. Chapman-Smith
asserts. “The WFC was asked to lead a
worldwide consultation on identity a few
years ago because it was agreed that
chiropractic lacked a clear market identity.
It’s extremely important for the future of
the profession that two broad consultations,
by the WFC and now Palmer, have produced
a consistent, agreed identity—in essence
chiropractors are the experts in spinal
health and well-being.”

Get connected

Our Alumni Office staff have met a number of our
international alumni and try to keep up-to-date on
their activities. But we know our knowledge of
your efforts is just the tip of the iceberg. If you’re
working to promote chiropractic in your home
country—in everyday ways or with groups such
as regional or country associations—and would
like to let us know about your activities, please fill
out the form at palmer.edu/alumni-update-form
or email us at alumni@palmer.edu.

Choose your program

This site uses javascript for a variety of aesthetic functions, but still works if disabled. Most scripting used on this site is for hiding and showing sections of pages which are visible if javascript is disabled.